Psychotherapy

B
O F F I C I A L P U B L I C AT I O N O F D I V I S I O N 2 9 O F T H E
A M E R I C A N P S Y C H O L O G I C A L A S S O C I AT I O N

www.divisionofpsychotherapy.org
U
In This Issue

Ad Hoc Committee on Psychotherapy:

Commitment to Scientist-Practitioner
L
Collaboration

Interview with Patricia Bricklin, Ph.D.,

Past President of Division 29
L
Therapeutic Work and Professional
Development: Main Findings and
E
Practical Implications of a
Long-Term International Study
T
O E
I
C
N
VOLUME 40 NO. 2
 Division of Psychotherapy  2005 Governance Structure
President
Leon VandeCreek, Ph.D.
117 Health Sciences Bldg.
School of Professional Psychology
Wright State University
Dayton, OH 45435
Ofc: 937-775-3944 Fax: 937-775-5795
E-Mail: Leon.Vandecreek@Wright.edu
President-elect
Abraham W. Wolf, Ph.D.
Metro Health Medical Center
2500 Metro Health Drive
Cleveland, OH 44109-1998
Ofc: 216-778-4637 Fax: 216-778-8412
E-Mail: axw7@po.cwru.edu
Secretary
Armand Cerbone, Ph.D., 2005
3625 North Paulina
Chicago IL 60613
Ofc: 773-755-0833 Fax: 773-755-0834
email: arcerbone@aol.com
Treasurer
Jan L. Culbertson, Ph.D., 2004-2006
Child Study Center
University of Oklahoma Hlth Sci Ctr
1100 NE 13th St
Oklahoma City , OK 73117
Ofc: 405-271-6824, ext. 45129
Fax: 405-271-8835
Email: jan-culbertson@ouhsc.edu
Past President
Linda F. Campbell, Ph.D.
University of Georgia
402 Aderhold Hall
Athens, GA 30602-7142
Ofc: 706-542-8508 Fax: 770-594-9441
E-Mail: lcampbel@uga.edu
COMMITTEES AND TASK FORCES
COMMITTEES
Fellows
Chair: Lisa Porche-Burke, Ph.D.
Phillips Graduate Institute
5445 Balboa Blvd.
Encino, CA 91316-1509
Ofc: 818-386-5600 Fax: 818-386-5695
Email: lpburke@aol.com
Membership
Chair: Rhonda S. Karg, Ph.D.
Research Triangle Institute
3040 Cornwallis Road
Research Triangle Park, NC 27709
Ofc: 919-316-3516 Fax: 919-485-5589
Student Development
Chair: Adam Leventhal, 2005
Department of Psychology
University of Houston
Houston, Texas 77204-5022
Ofc: 713-743-8600 Fax: 713-743-8588
E-mail: aleventhal@uh.edu
Nominations and Elections
Chair: Abe Wolf, Ph.D.
Professional Awards
Chair: Linda Campbell, Ph.D.
ELECTED BOARD MEMBERS
Board of Directors Members-at-Large
Norman Abeles, Ph.D. , 2003-2005
Michigan State Univ.
Dept. of Psychology
E. Lansing, MI 48824-1117
Ofc: 517-355-9564 Fax: 517-353-5437
Email: Norman.Abeles@ssc.msu.edu
James Bray, Ph.D., 2005-2007
Dept of Family & Community Med
Baylor College of Medicine
3701 Kirby Dr, 6th Fl
Houston , TX 77098
Ofc: 713-798-7751 Fax: 713-798-7789
Email: jbray@bcm.tmc.edu
Charles Gelso, Ph.D., 2005-2006
University of Maryland
Dept of Psychology
Biology-Psychology Building
College Park, MD 20742-4411
Ofc: 301-405-5909 Fax: 301-314-9566
Email: Gelso@psyc.umd.edu
Jon Perez, Ph.D., 2003-2005
IHS
Division of Behavioral Health
12300 Twinbrook Parkway, Ste 605
Rockville, MD 20852
Ofc: 202-431-9952
Email: jperez@hqe.ihs.gov
Finance
Chair: Jan Culbertson, Ph.D.
Education & Training
Chair: Jeffrey A. Hayes, Ph.D.
Counseling Psychology Program
Pennsylvania State University
312 Cedar Building
University Park, PA 16802
Ofc: 814-863-3799
E-mail: jxh34@psu.edu
Continuing Education
Chair: Steve Sobelman, Ph.D.
Department of Psychology
Loyola College in Maryland
Baltimore, MD 21210
Ofc: 410-617-2461
E-mail: sobelman@loyola.edu
Diversity
Chair: Jennifer F. Kelly, Ph.D.
Atlanta Center for Behavioral Medicine
3280 Howell Mill Road Suite 100
Atlanta, GA 30327
Ofc: 404-351-6789 Fax: 404-351-2932
E-mail: jfkphd@aol.com
Alice Rubenstein, Ed.D., 2004-2006
Monroe Psychotherapy Center
20 Office Park Way
Pittsford, NY 14534
Ofc: 585-586-0410 Fax: 585-586-2029
Email: akr19@aol.com
Libby Nutt Williams, Ph.D., 2005-2007
Department of Psychology
St. Mary’s College of Maryland
18952 E. Fisher Rd.
St. Mary’s City, MD 20686
Ofc: 240-895-4467 Fax: 240-895-4436
Email: enwilliams@smcm.edu
APA Council Representatives
Patricia M. Bricklin, Ph.D., 2005-2007
470 Gen. Washington Rd.
Wayne, PA 19087
Ofc: 610-499-1212 Fax: 610-499-4625
Email: pmb0001@mail.widener.edu
Norine G. Johnson, Ph.D., 2005-2007
13 Ashfield St.,
Roslindale, MA 02131
Ofc: 617-471-2268 Fax: 617-325-0225
Email: NorineJ@aol.com
John C. Norcross, Ph.D., 2005-2007
Department of Psychology
University of Scranton
Scranton, PA 18510-4596
Ofc: 570-941-7638 Fax: 570-941-7899
E-mail: norcross@scranton.edu
Program
Chair: Alex Siegel, Ph.D., J.D.
915 Montgomery Ave. #300
Narbeth, PA 19072
Ofc: 610-668-4240 Fax: 610-667-9866
E-mail: ams119@aol.com
Psychotherapy Research
Chair: William B. Stiles, Ph.D.
Department of Psychology
Miami University
Oxford, OH 45056
Ofc: 513-529-2405 Fax: 513-529-2420
Email: stileswb@muohio.edu
The Ad Hoc Committee on
Psychotherapy
Linda Campbell, Ph.D. and
Leon VandeCreek, Ph.D., Co-Chairs
Jeffrey Hayes, Ph.D. and Craig Shealy,
Ph.D., Education and Training
Jean Carter, Ph.D. and Alice
Rubenstein, Ed.D., Practice
Bill Stiles, Ph.D., Research
John Norcross, Ph.D., Chair
Publications Board
Norine Johnson, Ph.D., Representative
 PUBLICATIONS BOARD
John C. Norcross, Ph.D., 2005-2007 Psychotherapy Journal Editor
Department of Psychology Charles Gelso, Ph.D., 2005-2010
University of Scranton University of Maryland
Scranton, PA 18510-4596 Dept of Psychology
Ofc: 570-941-7638 Fax: 570-941-7899 Biology-Psychology Building
E-mail: norcross@scranton.edu College Park, MD 20742-4411
Ofc: 301-405-5909 Fax: 301-314-9566
Jean Carter, Ph.D., 1999-2005 Gelso@psyc.umd.edu
3 Washington Circle, #205
Washington, D.C. 20032 Psychotherapy Bulletin Editor
Ofc: 202-955-6182 Craig N. Shealy, Ph.D., 2004-2006
jeancarter5@comcast.net Department of Graduate Psychology
James Madison University
Lillian Comas-Dias, Ph.D., 2001-2006 Harrisonburg, VA 22807-7401
Transcultural Mental Health Institute Ofc: 540-568-6835 Fax: 540-568-3322
908 New Hampshire Ave. N.W., #700 shealycn@jmu.edu
Washington, D.C. 20037
cultura@erols.com Internet Editor
Bryan S. K. Kim, Ph.D., 2005-2007
Raymond A. DiGiuseppe, Ph.D., 2003-2008 Counseling, Clinical, and School Psychology Program
Psychology Department Department of Education
St John’s University University of California
8000 Utopia Pkwy Santa Barbara, CA 93106-9490
Jamaica , NY 11439 Ofc & Fax: 805-893-4018
Ofc: 718-990-1955 bkim@education.ucsb.edu
DiGiuser@STJOHNS.edu
Student Website Coordinator
Alice Rubenstein, Ed.D., 2000-2006 Nisha Nayak
Monroe Psychotherapy Center University of Houston
20 Office Park Way Dept of Psychology (MS 5022)
Pittsford, NY 14534 126 Heyne Building
Ofc: 585-586-0410 Fax 585-586-2029 Houston, TX 77204-5022
akr19@aol.com Ofc: 713-743-8600 or -8611 Fax: 713-743-8633
nnayak@uh.edu
George Stricker, Ph.D., 2003-2008
Institute for Advanced Psychol Studies
Adelphi University
Garden City, NY 11530
Ofc: 516-877-4803 Fax: 516-877-4805
stricker@adelphi.edu

PSYCHOTHERAPY BULLETIN
Psychotherapy Bulletin is the official newsletter of Division 29 (Psychotherapy) of the American Psychological
Association. Published four times each year (spring, summer, fall, winter), Psychotherapy Bulletin is designed to:
1) inform the membership of Division 29 about relevant events, awards, and professional opportunities; 2) provide
articles and commentary regarding the range of issues that are of interest to psychotherapy theorists, researchers,
practitioners, and trainers; 3) establish a forum for students and new members to offer their contributions; and,
4) facilitate opportunities for dialogue and collaboration among the diverse members of our association.

Contributors are invited to send articles (up to 4,000 words), interviews, commentaries, letters to the editor,
and announcements to Craig N. Shealy, Ph.D., Editor, Psychotherapy Bulletin. Please note that Psychotherapy
Bulletin does not publish book reviews (these are published in Psychotherapy, the official journal of Division
29). All submissions for Psychotherapy Bulletin should be sent electronically to shealycn@jmu.edu; please ensure
that articles conform to APA style. Deadlines for submission are as follows: February 1 (spring); May 1
(summer); August 1; November 1 (winter). Past issues of Psychotherapy Bulletin may be viewed at our website:
www.divisionofpsychotherapy.org. Other inquiries regarding Psychotherapy Bulletin (e.g., advertising) or
Division 29 should be directed to Tracey Martin at the Division 29 Central Office (assnmgmt1@cox.net or
602-363-9211).

DIVISION OF PSYCHOTHERAPY (29)

Central Office, 6557 E. Riverdale Street, Mesa, AZ 85215
Ofc: (602) 363-9211 • Fax: (480) 854-8966 • E-mail: assnmgmt1@cox.net
www.divisionofpsychotherapy.org
 N O F P S Y C H O THE
O
DIVISION OF PSYCHOTHERAPY Non-Profit

RA P Y
D I V I SI

American Psychological Association Organization

29 6557 E. Riverdale U.S. Postage
Mesa, AZ 85215 Paid

ASSN.
AMER I

Utica, NY
Permit No. 83
www.divisionofpsychotherapy.org
AL
C
A
N PSYCHOLOGI C
 PSYCHOTHERAPY BULLETIN
Official Publication of Division 29 of the
American Psychological Association
PSYCHOTHERAPY BULLETIN
Volume 40, Number 2
Published by the
DIVISION OF
PSYCHOTHERAPY
American Psychological Association CONTENTS
6557 E. Riverdale
President’s Column ................................................2
Mesa, AZ 85215
602-363-9211
e-mail: assnmgmt1@cox.net Student Feature: Fostering Self-Awareness ........4

Ad Hoc Committee on Psychotherapy:

EDITOR Commitment to Scientist-Practitioner
Craig N. Shealy, Ph.D. Collaboration ........................................................9

CONTRIBUTING EDITORS Interview with Patricia Bricklin, Ph.D.,

Washington Scene Past President of Division 29............................12
Patrick DeLeon, Ph.D.
Recent Trends in Internship Training ................13
Practitioner Report
Ronald F. Levant, Ed.D.
Washington Scene: A Few Dedicated
Education and Training Visionaries ..........................................................21
Jeffrey A. Hayes, Ph.D.
2005 Rosalee G. Weiss Lecturer:
Psychotherapy Research
Dr. Marvin R. Goldfield ....................................26
William Stiles, Ph.D.

Student Feature Therapeutic Work and Professional

Adam Leventhal Development: Main Findings and
Practical Implications of a Long-Term
STAFF International Study ............................................27
Central Office Administrator
Tracey Martin 2005 Recipient of the APA Distinguished
Contributions to Education & Training ..........33

Membership Application......................................35

Website
www.divisionofpsychotherapy.org

N O F P S Y C H O THE
O
RA P Y
D I V I SI

29
ASSN.
AMER I

AL

C
A
N PSYCHOLOGI C
PRESIDENT’S COLUMN
Leon VandeCreek, Ph.D.
One of the exciting
and challenging
aspects of serving
as president of
Division 29 is that
I get to participate
in many of the cut-
ting edge issues of
the committees of
the Division. You
would be pleased
to know that many
psychologists are actively working on ini-
tiatives for psychotherapy. I will highlight
a few of them here, and others have
described them elsewhere in this issue.
Linda Campbell, past-president, and I have
continued to consult on a regular basis
about the initiatives that were begun last
year. She and I have hosted conference calls
with members of the Research Committee
(Bill Stiles is the committee chair) and with
members of the Professional Practice
Committee (Jean Carter and Alice
Rubinstein are co-chairs). We have found
these conference calls to be a very efficient
and effective way to keep informed about
committee work and to keep enthusiasm
high. Some of these initiatives are
described by Linda Campbell in this issue.
We expect to have similar calls in the next
month with both the Membership
Committee and the Training Committee.
One of the exciting developments has been
the continued expansion of the division’s
web page. Bryan Kim has added several
new features. It will soon be possible to
apply for membership online (including
payment) without needing to download or
mail the application form. Please encour-
age your colleagues to join; it is easy and
inexpensive. Another new feature of the
web page is the Research Clearinghouse
which provides an opportunity for
2
researchers to list their research projects
and to invite participation. All of us prob-
ably receive periodic requests from
researchers to serve as subjects or partici-
pants, but we hope that our Research
Clearinghouse will encourage researchers
to invite others in the division to partici-
pate in projects in a variety of ways. For
example, researchers could invite practi-
tioners to participate by collecting client
data, or researchers could invite practition-
ers and trainers and other researchers to
play a role in the design of a project. We
hope the Clearinghouse will be attractive
to many members of the division.
One of APA President Ron Levant’s initia-
tives is to gain some consensus on evi-
dence-based practice in psychology (EBPP).
He established a task force that developed a
draft policy statement. The members of the
Ad Hoc Committee on Psychotherapy:
Commitment to the Scientist-Practitioner
Collaboration discussed this statement and
made recommendations that I submitted to
the task force. Our recommendation was to
include the phrase “psychologically-based
psychotherapy” in the definition of EBPP
and we referenced a definition of psy-
chotherapy that was adopted by the divi-
sion in 2002. That definition reads as fol-
lows: “Psychotherapy is the informed and
intentional application of clinical methods
and interpersonal stances derived from
established psychological principles for the
purpose of assisting people to modify their
behaviors, cognitions, emotions, and/or
other personal characteristics in directions
which the participants deem desirable.”
Our recommendation to insert the phrase
“psychologically-based psychotherapy”
was consistent with our on-going effort to
increase the presence of the word “psy-
chotherapy” in clinical literature and policy
statements. As Linda Campbell noted last
year in one of her presidential columns, this
word has disappeared from many policy
documents and has been replaced by broad-
er phrases, such as “methods of interven-
tion” which includes procedures that are
not psychotherapy. The upshot of this shift-
ing terminology is that training programs
and accreditation bodies do not require that
students receive training in psychotherapy,
but rather in methods of intervention. We
want to keep the word psychotherapy front
and center for the profession.
Our discussion about the policy statement
on evidence-based practice led to another
exciting idea, namely that we are poorly
informed about the role of clinical judg-
ment and expertise of psychotherapists in
providing care to our clients. Some
researchers contend that practitioners
should only use empirically supported
treatments which usually refers to those
treatments that have found research sup-
Find Division 29 on the Internet. Visit our site at
www.divisionofpsychotherapy.org
port in rigidly controlled studies. The role
of the clinician’s judgment in tailoring
treatments to match the unique needs of
each client is usually excluded from this
line of research. Yet, the experiences of
practitioners tell us that few clients match
the inclusion criteria of the research studies
and most of our clients are too complex for
us to be bound by laboratory criteria. We
really need to know more about the role of
clinical judgment in selecting and imple-
menting treatment. In response to our dis-
cussion, the Practice Committee has sug-
gested to our journal editor that a special
section of the journal be devoted to clinical
judgment and he has enthusiastically
agreed.
A lot is happening in the division and we are
always interested in hearing from you. I am
easy to contact at leon.vandecreek@
wright.edu.
3
STUDENT FEATURE
Fostering Self-Awareness: Moving in the Direction of
Empirically-Based Training
Scott D. McDonald
Virginia Commonwealth University
Abstract
Self-awareness is regarded as an essential
characteristic of the competent, well-func-
tioning therapist. However, it is unclear
whether general didactics and supervision
practices are effective at fostering self-
awareness. Recent findings suggest that an
evidence-based training approach, using
self-reflection, improves self-awareness
and subsequently clinical skills. This article
asserts that self-reflection, particularly
when paired with self-practice, is a tech-
nique that can be used to enrich personal
awareness, clarify the mechanisms of
change, and deepen the understanding of
the therapeutic process.
Fostering Self-Awareness: Moving in the
Direction of Empirically-Based Training
Fellow therapist trainees: Let me begin by
asking a few questions about your most
recent intake session. In your best estima-
tion: 1. How would the client rate the qual-
ity of the therapeutic bond? 2. Did you and
the client have a common perception of his
or her goals for therapy? 3. Did you and
the client have a common perception of
what tasks would be important in therapy?
And lastly, 4. Do you think the client will
return for another session?
Now, let me ask two more questions. How
much confidence do you have in your
answers? Do you feel that your estimate of
quality of the therapeutic alliance and like-
lihood of client return would correspond to
your client’s experience? If you are like
many trainees, you probably rationalized
that, regardless of how good or bad, your
ratings were fairly accurate. But according
to a recent study described in Professional
Psychology: Research and Practice, the thera-
pist trainee is a poor judge of the client’s
4
experience in the intake session. In fact,
although client and observer quality rat-
ings of the therapeutic working alliance
and likelihood of return were comparable,
therapist trainee ratings on analogous
measures bore little resemblance to client
ratings, even after a year of supervised
clinical practice.
For the abovementioned study, O’Donovan,
Bain and Dyck (2005) recruited 61 therapist
trainees from clinical psychology programs
and clinical apprenticeships (both
approaches can lead to licensure in
Australia). At the beginning of therapist
training and one year later, trainees con-
ducted intake interviews with researcher
confederates who assumed standardized
patient profiles. The researchers found that
although the client and observer were in
strong concord on ratings of rapport,
agreement on therapeutic goals and tasks,
and ratings of likelihood of returning for
future sessions, ratings by trainees did not
match those of the clients.
What could account for the inaccuracy?
O’Donovan and colleagues (2005) suggest-
ed that although the trainees in their study
may have properly followed protocol and
techniques appropriate for conducting an
intake session (i.e., building rapport, iden-
tifying the problem, and setting goals),
they had not yet developed a depth of
awareness that would allow them to dis-
cern the experience from the client’s per-
spective. However, lack of experience
alone may not have been to blame. In fact,
therapists with substantially more experi-
ence than O’Donovan’s trainees appear to
suffer the same inclination to misread
clients’ dispositions. An earlier study by
Hill and colleagues (1993) asked therapists
with an average of ten years postgraduate
clinical practice to anticipate what
thoughts or feelings their clients experi-
enced but did not relay during therapy ses-
sions. Results indicated that although
clients reported hiding negative thoughts
and feelings during the session, the thera-
pists were seldom aware of their clients’
reactions.
In clinical psychology, a tenet of profes-
sional competence is the possession of
a self-awareness of biases, stereotypes,
and self-schemas that can interfere with
treatment (American Psychological
Association, 2002). Along those lines, sev-
eral sources have emphasized that build-
ing a student’s self-awareness is critical in
training (e.g., Sue et al., 1998). In fact, the
Council of Chairs of Training Councils
(CCTC)—the umbrella system of doctoral,
internship, and postdoctoral training coun-
cils in professional psychology—recently
developed a document designed, in part,
to notify students and trainees that their
academic performance will be evaluated
across a wide spectrum of competency areas,
including but not limited to sufficient self
awareness (see http://gradpsych.apags.org/
jun04/competence.cfm). Moreover, surveys
of both practicing licensed psychologists
and heads of doctoral clinical, counseling,
and school psychology programs agreed
that self-awareness was the leading con-
tributor to whether a psychologist is able to
function in an unimpaired manner
(Schwebel & Goster, 1998). Furthermore, in
a more recent study, interviews with high-
ly-regarded therapists revealed that aware-
ness of their own issues and the under-
standing that personal issues had the
potential to impact the therapy session was
a primary ethical value (Jennings,
Sovereign, Bottorff, Mussell, & Vye, 2005).
How can therapists improve
their self-awareness?
In light of their findings with trainees sum-
marized above, O’Donovan and colleagues
(2005) recommended that experiential
aspects of therapist training programs, in
addition to didactic seminars, should
include the formal practice of self-
reflection to improve the burgeoning
professional’s ability to accurately judge
their therapeutic work (see also
http://gradpsych.apags.org/jun04/com-
petence.cfm). The recommendation that
self-reflection be included as part of clinical
training was not derived in a vacuum,
however. A quick search of the literature
reveals several examples of how self-reflec-
tion has been identified as a valuable com-
ponent of professional training programs
in medicine (Niemi, 1997), nursing (Marita,
Leena, & Tarja, 1999), marriage and family
therapy (Naden, Johns, Ostman, & Mahan,
2004), and music therapy (Camilleri, 2001).
Self-reflection, which refers to a “metacogni-
tive skill that encompasses observation,
interpretation and evaluation of one’s own
thoughts, emotions, feelings, and actions”
(Bennet-Levy et al., 2001) is thought to be a
key element in the learning of new skills
(Schön, 1987). Practicing self-reflection can
foster a deeper understanding of technical-
rational knowledge (i.e., textbook learning
and lecture) and the mechanisms through
which particular techniques work. Although
didactics lay the foundation for professional
development, self-reflection helps the trainee
mature a sense of “professional artistry,” an
important component of professional com-
petence that involves self-awareness and
versatility in practice. In his seminal work,
The Reflective Practitioner, Schön (1983)
described the process of self-reflection:
When a practitioner reflects in and on
his practice, the possible objects of his
reflection are as varied as the kinds of
phenomena before him and the systems
of knowing-in-practice which he brings
to them. He may reflect on the tacit
norms and appreciations which under-
lie a judgment, or on the strategies and
theories implicit in a pattern of behav-
ior. He may reflect on the feeling for a
situation which has led him to adopt a
particular course of action, on the way
in which he has framed the problem he
is trying to solve, or on the role he has
constructed for himself within a larger
institutional context.
5
Can clinical training improve self-awareness?
Certainly, as this author’s Director of
Clinical Training recently pointed out, self-
awareness takes the guise of various “gen-
eral” factors in clinical competence such as
supervisablity, maturity, and motivation to
improve. Unfortunately, it is unclear from
the literature whether standard didactics
and supervised experience alone leads to
the trainee developing self-awareness. In
fact, as the results of O’Donovan et al.
(2005) indicate, a full year of supervised
clinical training did not improve trainee’s
ability to accurately judge their therapeutic
work.
On the other hand, there is some evidence
that programs implementing specific pro-
tocols utilizing self-reflection have been
successful in improving clinical skills
(Bennett-Levy, et al., 2001; Marita et al.,
1999). For example, Bennett-Levy and col-
leagues (2001) performed a qualitative
study of a course in cognitive therapy that
included self-reflection paired with self-
practice, such as completing thoughts
records, setting personal goals, and con-
ducting behavioral experiments. At the
end of the course, participants reported a
deeper understanding of the therapeutic
process which was useful as a therapist but
also in their personal lives. Specifically,
they reported an enhanced understanding
of the therapist role, cognitive theory, and
the mechanisms by which change
occurred. As one participant conveyed,
Although I already knew that emotions
are a result of our interpretation of
events, this situation gave me a good
example of that from my own experi-
ence. So rather than just “knowing”
about this phenomenon I “realized” it –
the difference between understanding
the concept at a head level and gaining
an unquestionable, full-bodied experi-
ence of understanding (p. 211).
Many participants also reported enriched
personal awareness:
The whole process has taught me things
about myself, the way I think, and the
6
way I unconsciously sabotage the posi-
tive. I am now aware of Little Miss
Nasty, who rears her ugly head whenev-
er something positive happens (p. 213).
Results also suggested participants experi-
enced an enrichment of therapist skills and
developed stronger self-concepts as thera-
pists. In the words of one trainee,
What it has truly given me is a belief, a
belief that cognitive therapy works, that I
am capable of doing cognitive therapy
and that I can help clients do cognitive
therapy. Empirical and scientific ground-
ing helped me to believe in the efficacy of
cognitive therapy. Practice and reflection
demonstrated I could do it. Reflection
and my own experience of cognitive ther-
apy techniques gave me confidence that I
had what it took to help my clients use
cognitive therapy (p. 214).
How does one practice self-reflection?
There are several avenues to increasing self-
awareness through the use of self-reflection.
One approach is for the trainee to enter ther-
apy as a client (Ramos-Sanchez et al., 2002).
However, despite the requirement of analy-
sis for the practitioner of psychoanalysis
(Prochaska & Norcross, 1999) and limited
evidence that personal therapy improves
skills and attitudes used in practice (Macran,
Stiles, & Smith, 1999), it is unclear whether
experience as a client has an impact on a
therapists clinical effectiveness (Macaskill,
1988; Macran & Shapiro, 1998).
Perhaps a better option is for the trainee to
practice self-reflection techniques during
supervised practica, such as watching tapes
of therapy sessions, keeping a “learning
log” of clinical experiences (Niemi, 1997),
writing periodic reflection papers (Nadan
et al., 2004), and role-playing from a client’s
viewpoint with colleagues (Beck, Rush,
Shaw, & Emery, 1979). In addition, there is a
growing emphasis, particularly in cognitive
therapy, for therapists to practice tech-
niques on themselves and reflect on the
experience (Bennett-Levy et al., 2001). As
Padesky (1996) succinctly declared, “to
fully understand the process of the therapy,
there is no substitute for using cognitive
therapy methods on oneself.” (p. 288). The
Bennett-Levy et al. (2001) study reviewed
above illustrated an exemplar of self-prac-
tice and self-reflection, utilizing group
meetings, weekly diaries, and Grenberger
and Padesky’s (1995) Mind over Mood which
included thought records and self-guided
behavioral experiments. Furthermore,
interested therapists may benefit from tak-
ing advantage of other learning opportuni-
ties such as workshops on schema identifi-
cation (Padesky, 1996), practica experiences
in group therapy with an interpersonal
focus (Yalom, 1995), and becoming familiar
with the relevant literature (e.g., Schön,
1983, 1987; Von Wright, 1992).
In summary, self-awareness is regarded as
an essential characteristic of the competent,
well-functioning therapist. Furthermore,
therapists who are highly regarded by their
peers report self-awareness as one of their
core ethical values. However, it is unclear
whether general didactics and supervision
practices are effective at fostering self-
awareness. Recently, the practice of self-
reflection, particularly when paired with
self-practice, has gained support as a tech-
nique to enrich personal awareness, clarify
the mechanisms of change, and deepen the
understanding of the therapeutic process
(e.g., see http://www.apa.org/ed/gradu-
ate/cctcevaluation.pdf). Despite the appar-
ent agreement of the APA, clinical training
directors, and practicing clinicians that
self-awareness is a critical attribute of the
competent therapist, the paucity of
research that can inform training in this
area is perplexing. Furthermore, a review
of the four example student evaluation
forms in the Manual for Directors of Clinical
Training prepared by the Council of
University Directors of Clinical Psychology
(CUDCP, 2005) revealed that only two had
items that directly dealt with self-aware-
ness (e.g., “shows a sensitivity to his/her
own strengths and weaknesses”; “under-
stands clients impact on self.”). Clearly, a
more focused definition of “self-aware-
ness” is needed if clinical researchers are to
work towards developing a useful
research-based training agenda. Perhaps
the recent and above noted efforts by pro-
fessional organizations such as the Council
of Chairs of Training Councils—combined
with increased interest in empirically sup-
ported therapeutic relationships (e.g.,
Norcross, 2002)—will draw more eyes
toward this issue.
References
American Psychological Association
(2002). Guidelines on multicultural educa-
tion, training, research, practice, and organi-
zational change for psychologists. Retrieved
April 25, 2005, from http://www.apa.org/
pi/multiculturalguidelines/
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery,
G. (1979). Cognitive therapy of depression.
New York: The Guilford Press.
Bennett-Levy, J., Turner, F., Beatty, T.,
Smith, M., Paterson, B., & Farmer, S.
(2001). The value of self-practice of cog-
nitive therapy techniques and self-reflec-
tion in the training of cognitive thera-
pists. Behavioural and Cognitive
Psychotherapy, 29, 203-220.
Camilleri, V. A. (2001). Therapist self-
awareness: An essential tool in music
therapy. Arts in Psychotherapy, 28(1) 2001,
79-85.
Council of University Directors of Clinical
Psychology (CUDCP; 2005) Manual for
directors of clinical training. Retrieved
April 25, 2005, from http://www.am.org
/cudcp/DCT%20manual_rev05.pdf
Greenberger, D., & Padesky, C. A. (1995).
Mind over mood: A cognitive therapy treat-
ment manual for clients. New York: The
Guilford Press.
Hill, C. E., Thompson, B. J., Cogar, M. C., &
Denman, D. W. (1993). Beneath the sur-
face of long-term therapy: Therapist and
client report of their own and each
other’s covert processes. Journal of
Counseling Psychology, 40(3), 278-287.
Jennings, L., Sovereign, A., Bottorff, N.,
Mussell, M. P., & Vye, C. (2005). Nine
ethical values of master therapists.
Journal of Mental Health Counseling, 27(1),
32-47.
Macaskill, N. D. (1988). Personal therapy in
the training of the psychotherapist: Is it
7
 effective? British Journal of Psychotherapy,
4(3), 219-226.
Macran S, & Shapiro D. A. (1998). The role
of personal therapy for therapists: A
review. British Journal of Medical
Psychology, 71, 13-25.
Macran, S., Stiles, W. B., & Smith, J. A.
(1999). How does personal therapy affect
therapists’ practice? Journal of Counseling
Psychology, 46(4), 419-431.
Marita, P., Leena, L., & Tarja, K. (1999).
Nurses’ self-reflection via videotaping to
improve communication skills in health
counseling. Patient Education and
Counseling, 36, 3-11.
Naden, M., Johns, K., Ostman, C., &
Mahan, T. (2004). Student therapists
grapple with modern and postmodern
ideas: One program’s approach to train-
ing. Contemporary Family Therapy, 26(4),
465-480.
Niemi, P. M. (1997). Medical student’ pro-
fessional identity: Self-reflection during
the preclinical years. Medical Education,
31, 408-415.
Norcross, J. C. (2002). Psychotherapy rela-
tionships that work: Therapist contributions
and responsiveness to patients. New York:
Oxford University Press.
O’Donovan, A. Bain, J. D., & Dyck, M. J.
(2005). Does clinical psychology educa-
tion enhance the clinical competence of
practitioners? Professional Psychology:
Research and Practice, 36(1), 104-111.
Padesky, C. A. (1996). Developing cogni-
tive therapist competency: Teaching and
supervision models. In P. M. Salkovskis
(Ed.), Frontiers of cognitive therapy. (pp.
226-292). New York: The Guilford Press.
8
Prochaska, J. O., & Norcross, J. C. (1999).
Systems of psychotherapy: A transtheoretical
analysis (4th ed.). Washington, D.C.:
Brooks/Cole Publishing.
Ramos-Sanchez, L., Esnil, E., Goodwin, A.,
Riggs, S., Touster, L. O., Wright, L. K., et
al. (2002). Negative supervisory events:
Effects on supervision satisfaction and
supervisory alliance. Professional Psych-
ology: Research and Practice, 33, 197-202.
Schön, D. A. (1983). The Reflective practition-
er: How professionals think in action. New
York: Basic Books.
Schön, D. A. (1987). Educating the reflective
practitioner: Toward a new design for teach-
ing and learning in the professions. San
Francisco: Jossey-Bass.
Schwebel, M., & Coster, J. (1998). Well-
functioning in professional psycholo-
gists: As program heads see it.
Professional Psychology: Research and
Practice, 29(3), 284-292.
Sue, D. W., Carter, R. T., Casas, J. M.,
Fouad, N. A., Ivey, A. E., Jensen, M., et al.
(1998). Multicultural counseling competen-
cies: Individual and organizational develop-
ment. Thousand Oaks, CA: Sage.
Von Wright, J. (1992). Reflections on reflec-
tion. Learning and Instruction, 2, 59-68.
Yalom, I. D. (1995). The theory and practice of
group psychotherapy. (4th ed.). New York:
Basic Books.
Author Note
Correspondences concerning this article
should be sent to Scott D. McDonald,
Virginia Commonwealth University,
Department of Psychology, Clinical
Program, P.O. Box 842018, Richmond, VA
23284-2018. E-mail: smcdonal@vcu.edu
AD HOC COMMITTEE ON PSYCHOTHERAPY
Commitment to Scientist-Practitioner Collaboration
Linda Campbell, Ph.D., Co-Chair
The Ad Hoc
Committee on
Psychotherapy was
developed to
advance the role of
psychotherapy in
practice, training,
and research. This
mission was the
presidential
initiative of Pat
Bricklin, Linda
Campbell, and the current president, Leon
VandeCreek. This column in each issue of
the Bulletin will inform the membership of
the progress being made toward the fifteen
goals set as priority actions by the board of
directors.
Several activities have occurred since the
last Bulletin briefing and several of these
are addressed in the President’s Column.
Two major components of our priority
actions are continuing education opportu-
nities and collaboration with federal
grantors on psychotherapy research.
In a conference call with the practice repre-
sentatives on our committee, Jean Carter
and Alice Rubenstein, the need for addi-
tional vehicles for scientist-practitioner col-
laboration was discussed. Our research
and our practice membership are very
interested in working together to advance
clinically based psychotherapy research
and to be in the forefront of the evidence
based movement on clinical judgment and
clinical expertise. The ideas that our focus
groups and our leadership offer as an ini-
tial collaboration model include several
variations.
Practitioners are very involved in applied
research that focuses on the psychothera-
peutic process. Conventionally, when prac-
titioners participate with researchers, the
researchers benefit by advancing their
research project, but the practitioners
may not be able to benefit other than
altruistically (when we acknowledge it
as an important motive). The practice
and research focus groups suggest that
continuing education credit for types of
participation could be valuable. Further, a
clearinghouse function for practitioners
and scientists to match up for various
levels of collaboration would also be
valuable. These ideas take the form of the
following recommendations:
1. Practitioners who want to learn more
about clinically relevant psychotherapy
research could read articles in this
specific focus area, answer questions
provided by the author, and gain contin-
uing education credit for the activity.
This activity could also be expanded to
include a time designated chat room or
a web feature that allows practitioners
to discuss the article with the author.
This option allows participation at the
CE learner level but does not require
active participation in projects.
2. Practitioners may volunteer to partici-
pate as subjects in clinically based
research. This option could include
research geared to therapist variables,
client variables, relationship variables, or
outcome. The type and level of participa-
tion would depend on the subject of the
research. This option could be imple-
mented by researchers presenting their
ideas through a clearinghouse function
on our web site. Practitioners could select
those that most appeal to them.
3. A type of actual collaboration was sug-
gested in which researchers could
present their research questions and
9
 proposed methodology to our practi-
tioner participants in order to gain rec-
ommendations for practicality, imple-
mentation, pitfalls, and additional
complicating factors not considered.
Also, practitioners could identify the
strengths in the research questions and
other factors that enhance the project.
4. The clearinghouse function would also
make possible the equal collaboration
for practitioners and researchers to
work on a project from the beginning
together. There isn’t a mechanism cur-
rently within our division, nor else-
where as we know it, that promotes the
matching of practitioners who have spe-
cific clinically based research interests
with psychotherapy researchers of the
same interest areas. As these dialogues
begin and our membership becomes
more accustomed to this activity within
the division, a clearinghouse function
through the web would offer a vehicle
for practitioners and researchers to
begin their collaborations.
5. As Carol Goodheart and Jean Carter so
eloquently put it, “clinicians are
canaries in the coal mines.” The coal
miners carried canaries in cages with
them down those several miles into the
mines and knew when the canary could
not breathe, that only a short time later,
they too would not be able to breathe
the deadly, but odorless, gases. Our
Division of Psychotherapy is proud to
have among our membership, many
master psychotherapists who have
made and continue to make invaluable
contribution to the field and whose
influence has shaped the landscape of
clinical work immeasurably. These are
clinical experts who identify previously
unknown themes, patterns,
patient/client reactions, relationship
variables, client variables and their rela-
tionship to other factors, and many
other perceptions that are unlikely to be
known by researchers before they are
noted by practitioners.
10
Jean Carter and Alice Rubenstein suggest-
ed that practitioners could suggest
research questions to be considered for
adoption by psychotherapy researchers.
These questions would emanate from
observations made by practitioners but
which are not pursued by researchers in
the field. This possibility opens up a very
exciting potential for collaboration and for
early detection of ideas that have not been
formulated heretofore.
These practitioner-researcher collabora-
tion ideas are very exciting to those par-
ticipating and we would very much
appreciate hearing from you, our
membership, on your ideas or simply
your thoughts on these ideas.
Additionally, as reported in the last
Bulletin issue, our research members have
noted that psychotherapy research that
focuses on process variables, client or ther-
apist variables, and other worthy variables
for investigation are often not noted in the
criteria for federal funding of mental
health research. Our research members are
diligently composing a document that
described their issues and concerns regard-
ing consideration for federal grant money.
When the position paper is completed, the
Ad Hoc Committee representatives will
work within APA to determine how to pro-
ceed with the initiative. The 2005
Presidential Task Force on Evidence-Based
Practice has issued a draft for comment
(see President’s Column). This position
paper, if advanced through APA, further
documents the importance of clinical evi-
dence and expertise. The Ad Hoc
Committee is encouraged that the current
climate supports inclusiveness of clinical
variables in practice and therefore sets the
stage for our pursuit of these variables
being extended into psychotherapy
research criteria.
Please let us hear from you as you have
comments or ideas that contribute to our
mission of advancing psychotherapy. This
is an important pursuit and we need you,
the membership, to make this initiative
successful.
If any of our members are interested in
involvement in any activities described
here, please contact Linda Campbell
(lcampbel@uga.edu) or Leon VandeCreek
(Leon.VandeCreek@Wright.edu) and we can
steer you to the person conducting the activ-
ity. We will be highlighting an area of the Ad
Hoc Committee focus in each Bulletin. In the
next issue we will update you on the activi-
ties going on in practice. Please stay tuned
and stay connected to these important initia-
tives for psychotherapy.
11
INTERVIEW
INTERVIEW WITH PATRICIA BRICKLIN, PH.D.
Past President of Division 29
Amber Paukert, B.S.
University of Houston
Paukert: Dr. Bricklin,
can you give me a
summary of your
professional history
starting with where
you went to gradu-
ate school and end-
ing with what you
are doing today?
Dr. Bricklin:
Patricia Bricklin, Ph.D.
Actually, my profes-
sional career began a little bit before I went
to graduate school. I majored in English
and journalism in college and I wanted to
be a writer. One summer while I was still in
college, I got a job at a small private resi-
dential school for children. They were 3 to
12 years old and they had moderate to
severe special needs. I fell in love with the
children and I was intrigued by all of the
issues surrounding them. I decided to go to
graduate school mostly to learn a little bit
about these children and what contributed
to their problems. I decided to apply to
graduate school at Johns Hopkins
University because I had heard good
things about their psychology program. It
was there that I experienced discrimina-
tion; they let me take courses, but when I
applied for the doctoral program, I was
turned down, specifically because I was a
woman. I will never forget the words of the
professor who interviewed me: “If we
thought that you were never going to get
married and you were never going to have
children, we would let you into the pro-
gram. Your grades are great, everything is
fine. But, you would take the place of a
man.” So, I didn’t go to Johns Hopkins
12
University for graduate school. I went to
Temple University in Philadelphia, and
received my doctorate in clinical psycholo-
gy with a focus on children with language,
learning, and emotional disorders. In grad-
uate school I met my husband, Barry, also a
clinical psychologist-to-be. We married
and along with completing our disserta-
tions we had two sons. In addition to my
role as wife and mother I was on the facul-
ty at Temple for a while and I worked with
children and their families in two private
schools that were very much like the one in
which I began my career.
To my surprise, I got a phone call one day
asking me to be a guest on a popular daily
radio show. Out of that guest appearance,
I was invited to do a continuous daily
radio and later, a television show with my
husband. Although there were few psy-
chologists in the media at that time, the
two of us accepted the challenge and
began what became a very important part
of our professional career for fifteen years.
One thing I observed about myself was
that I never seemed to leave one job for
another, but just kept adding them.
During the last twenty years I added doc-
toral training at Hahnemann University
and Widener University and developed a
special interest in the Psy.D model.
Additionally I focused on the legal, ethical
and regulatory aspects of psychology as a
profession through my work on and with
licensing boards.
Paukert: Wow, you’ve done a lot. I’m
interested in how you have integrated your
professional and personal life through all
of this.
Dr. Bricklin: Radio and television were
the first place, although it doesn’t seem
like a likely spot. It was during that time
that our family grew and we had four chil-
dren, two boys and two girls. The part of
the show that most interested our listeners
was not so much the psychology we talked
about, but our own relationship with each
other and the children. On a day to day
basis I worked out my role as a profes-
sional and a wife and a mother with an
audience of over a million people. We
talked about most of the stresses and joys
of daily life. My husband was a very
assertive person and I was very shy.
People used to write letters telling him to
not talk so much and to let me talk more.
We really worked out our relationship on
the radio and I also used our children as
examples of some of the things I was
struggling with as a mother of young chil-
dren. I used them to discuss issues like bed
time, adjusting to school, helping children
with homework and what you do in the
supermarket when your child is throwing
a tantrum and everyone is looking at you.
Over the years, some sad things happened
in our family and some happy things and
all of them happened while we were on
the air and they became things we could
develop as examples and issues for
problem solving.
In those days, if you wanted to be an ethical
psychologist, you couldn’t give advice on
the air if somebody asked a question. You
weren’t ethically allowed to advise them.
You could only talk about the issue and
give them examples in a very general way.
We struggled with maintaining the integrity
of psychology, the integrity of our family,
and providing people with something that
kept them listening and that they could
learn and profit from. It was truly a chal-
lenge and very rewarding. We still meet
both fathers and mothers who say “I raised
my children listening and watching you.”
Paukert: How do you think radio and tele-
vision psychologists are different now, and
what do you think of these differences?
Dr. Bricklin: I think the biggest difference
is that today is the day of the sound bite
and people want a quick fix. Unless you
can say what you’re going to say quickly
and catch people immediately, they’re not
going to stay with you. That makes it hard-
er for the psychologist or the professional-
ly trained person to do their job; there is no
real time to build a relationship with an
audience. Although I think there are some
very qualified people on the air right now,
it is difficult for the consumer to know who
is qualified and who is not. Almost anyone
can do a psychology type show and there
are fewer boundaries.
Paukert: Stemming from the ethical dilem-
mas of television and radio psychologists,
how do you think ethics have changed
over the course of your career?
Dr. Bricklin: Oh, I think they’ve changed
quite a bit. Psychology has become a regu-
lated profession. Ethics are both guiding
principles and regulatory codes of conduct.
We’ve become a much more litigious
world. Because ethics have become part of
the regulatory world, I think there’s a lot
more concern and even fear. The psychol-
ogist’s concern is about risk management
of their practice, and certain areas of psy-
chology are more risky than others. This
has affected the way people look at ethics.
I think in one sense, people have become
much more conscious of what is ethical
and what is not. On the other hand, I think
people used to think that ethics were in
many ways absolute and that is just not the
case. However, people want yes or no
answers and basically a lot of the answers
are not yes or no answers. Students for
some reason, really want a yes or no
answer, they want to know what they need
to do, to do things correctly, but a lot of the
issues you confront in practice, in research,
and in teaching, are not cut and dry and it’s
a little hard to live in that kind of a world.
I think most of us have come to understand
that besides some very basic ethical truths,
a lot about ethics is dynamic and almost
13
never absolute. Many of the problems that
people confront today are ethical dilemmas
where there are really no absolute wrong
or right answers. Ethical decision making
and critical thinking, problem solving
models are most useful.
Paukert: How has licensing changed over
the years?
Dr. Bricklin: Licensing has changed over
the years in the sense that the first activity
of licensing boards was to get qualified
people licensed. As time goes on, we are
still concerned with what should be the
qualifications of somebody who is
licensed, but the disciplinary part of licens-
ing has increased and the focus of licensing
boards now is not only to act as sort of a fil-
ter to make sure only qualified people are
licensed, but also act to in a disciplinary
way to make sure consumers are protected
from psychologists who don’t pay atten-
tion to what they’re supposed to do, and I
think that’s a change. The practice of psy-
chology is an evolving process and the
licensing process must keep pace. Issues of
interdisciplinary practice, mobility,
increased scope of practice (like prescrib-
ing) are all issues that must be considered.
Paukert: Switching topics somewhat, you
mentioned that you experienced some
adversity entering the field as a woman; do
you think that women still experience
adversity entering the field?
Dr. Bricklin: Yes, I think that women expe-
rience it differently depending on the part
of psychology that they’re interested in
pursuing. I don’t think that women experi-
ence adversity particularly in getting into
doctoral programs. There are still, from
what I understand, in some academic
programs, issues of promotion and tenure
that are sometimes problematic.
Discrimination is more subtle today. I don’t
think the areas of discriminations are as
easy to identify as they were.
14
Paukert: Can you tell me a little bit about
your involvement in Division 29 and APA
in general?
Dr. Bricklin: I had always been an advocate
for children and their families and did a lot
of public relations kind of work and talked
and raised money and made sure laws got
passed in my state that had to do with
children and their families, but I never really
thought about being an advocate for pro-
fessional issues in psychology until I got
involved in the state psychological associa-
tion. I did a lot of work with them all the
way up to being president of the associa-
tion and of course the next step to that was
becoming a council rep to APA from the
state. For the first ten years or so, most of
my APA activity was done as a representa-
tive of Pennsylvania to various parts of
APA. Then, I served on a number of APA
boards and committees. Most recently, I
was chair of the APA Committee for the
Advancement of Professional Practice.
Division 29 was one of my favorite divi-
sions. I went to their midwinter meetings
all the time. I read the journals. I was active
as a member and a fellow in the division’s
work, but I had never held an office in the
division. Bob Resnick, who was then presi-
dent of division 29, called me and asked
me if I would run for president of Division
29. I said, “Look, I’ve been very active in
the division as a member and a fellow, but
I have never held office, I don’t think I’m
prepared” and he, along with several other
people, talked me into doing it and that got
me right smack in the middle of the gover-
nance of Division 29. I loved and valued it.
I find I like Division 29 particularly
because of the integration that 29 has of
practice, science, and academics. The active
members of the division are a combined
group; they are either people who do a lit-
tle bit of all of those things or else they’re
scientists, researchers, academics, or practi-
tioners. All of them coalesce around the
area of psychotherapy in its broadest sense
and I find this a really powerful group and
love to be part of it.
Paukert: What do you think were your
most important contributions to Division
29 during your presidency?
Dr. Bricklin: There are two things that
occur to me. The year that I was president,
Division 29 was in a temporary financial
situation, in which many divisions find
themselves, and I thought, “Well, this is not
the time for a presidential initiative or any
costly activities. I think one of the things
that would be most helpful to the division
would be to focus on an active year but not
spend any more money than we need to,
and not put us any further into debt.” It
turns out that that year happened to be
a critical year for us getting back on keel.
In addition, I had the opportunity to
work with Linda Campbell and Leon
VandeCreek, to plan a long term initiative
that would look at the field of psychother-
apy from the standpoint of research, train-
ing and, practice. The purpose would be to
articulate the state of the art in each of
those three areas to determine what’s
needed and where some of the difficulties
may be. That initiative has taken off and it
seems the results may make a very big con-
tribution to the field of psychotherapy. It
was during my presidency that we had the
time to talk about such an initiative and
Bulletin ADVERTISING RATES
Full Page (8.5” x 5.75”) $300 per issue
Half Page (4.25” x 5.75”) $200 per issue
Quarter Page (4.25” x 3”) $100 per issue
Send your camera ready advertisement,
along with a check made payable to
Division 29, to:
Division of Psychotherapy (29)
6557 E. Riverdale
Mesa, AZ 85215
plan it carefully. I’m really delighted to see
Linda, Leon, along with others, moving it
forward. I am currently pleased to be serv-
ing Division 29 as Council representative
and hope to make a contribution there to
both Div. 29 and APA.
Paukert: My last question is, what advice
would you give students entering the field
today?
Dr. Bricklin: Be optimistic and be fully
engaged in the field. I would suggest that
people look at the field very carefully, look
at the many parts of it, pick the program
that you want to go to carefully in terms of
its focus. Be aware that psychology is a con-
stantly evolving field and that’s the most
exciting part about it. If you ask anybody
that is more than 20 years out of a doctoral
program, the psychologists they are today
are not exactly what they were trained to
do. The field of psychology that you’re
learning about today is evolving and you
have to look at it as, “I’m learning this as
the information that will help me to devel-
op the field.” Keep an open mind, recogniz-
ing that what you’re learning, you’re not
learning as something that’s going to stand
still. Love what you do, and be an active
part of the field as it moves forward.
Deadlines for Submission
August 1 for Fall Issue
November 1 for Winter Issue
February 1 for Spring Issue
May 1 for Summer Issue
All APA Divisions and Subsidiaries (Task
Forces, Standing and Ad Hoc Committees,
Liaison and Representative Roles) materials
will be published at no charge as space allows.
15
FEATURE
Recent Trends in Internship Training
Joyce Illfelder-Kaye, Ph.D.
Pennsylvania State University
Joyce Illfelder-Kaye is the Associate Director of
Training at the Center for Counseling and
Psychological Services at the Pennsylvania State
University. She is also the Vice Chair of the
Board of APPIC (The Association of Postdoctoral
and Psychology Internship Centers).
The internship experience continues to be
one of the capstone experiences in the train-
ing of doctoral students in clinical, counsel-
ing and school psychology. Depending on
when the reader completed the internship
experience, some of the changes in the expe-
rience of seeking an internship and complet-
ing an internship might be surprising.
Technological changes have helped to sub-
stantially improve the internship selection
process. At the same time some recent trends
in the field have intensified the anxiety stu-
dents are experiencing about the internship
process. Since most clinical, counseling and
school psychologists in training are expected
to complete an internship as a final require-
ment before receiving their degree, data col-
lected at the internship juncture can also
provide a snapshot for trends and changes
in the profession. This column is designed to
provide an update on the recent technologi-
cal changes in the application and selection
process and to highlight some recent trends
in graduate training.
Technological Changes
Intern applicants of today have grown up
in a technological era. Recent technological
changes in the internship application and
selection process represent an effort to
keep pace with the technological develop-
ments in society at large. These changes are
outlined below and include the APPIC
Directory on Line, the APPIC Application
for Psychology Internships, and the APPIC
16
Computer Match.
APPIC Directory on Line: Intern applicants
have always needed to collect information
about potential sites prior to submitting
applications for internship. The APPIC
Directory has long been the initial resource
for obtaining information about internship
sites. Applicants at a minimum would col-
lect addresses from the directory and send
post-cards to sites requesting their
brochures. Any student seeking an intern-
ship or post-doc can now access the APPIC
Directory on Line (DoL) through the
APPIC website at www.appic.org, in addi-
tion to the printed directory. This format
has provided APPIC member internship
and post-doc sites with an opportunity to
include more information about their sites,
in addition to electronic links to their own
institutional program website, and the e-
mail addresses of the training director.
Students can search the DoL according to
specified criteria, including geography
related search options, time-related search
option (application due dates), program-
related search options (accreditation status
of internship or post-doc, agency type,
type of program from which applicants are
accepted), position-related search options
(full-time versus part-time, stipend
amounts, and number of interns). Finally
applicants can search on training opportu-
nities provided (populations, treatment
modalities, and specialty areas).
APPIC Application for Psychology Internships
Students applying for internships now
complete a universal application form,
rather than different applications for
each site. The APPIC Application for
Psychology Internships, known in short as
the AAPI, has mostly replaced the individ-
ually designed applications used by each
training site. It is available on line on the
APPIC website as a word document, and
students are asked to complete it and to
submit it individually to each site in which
they are interested. It is a long document,
and it does take students a while to com-
plete, however, it is no doubt a shorter
process than in the past when students
completed 15 different applications for 15
different sites. APPIC member programs
have been strongly encouraged to use the
AAPI, and when we last inquired all but 13
sites were using the AAPI. Exploration
continues into the possibility of a truly on-
line AAPI that could be electronically sub-
mitted via a website to a specified list of
programs, but exploration into other pro-
fessional fields that are using such models
has not yet yielded a highly compelling
option. Our training sites still vary in
terms of their own technological resources
and capabilities for receiving electronic
applications. It should be noted that there
is not a universal application for APPIC
post-doctoral programs at this time.
APPIC Computer Match
The APPIC Computer Match which is run
in conjunction with National Matching
Service (NMS) has replaced the old intern-
ship call day. Applicants for psychology
internship must now register with NMS
during the fall of the year that they are
applying for internships. Sites must also
register with NMS. Applicants submit their
applications to individual sites, and inter-
view with those who invite them to do so,
as they always did. In early February by a
date that is specified each year, applicants
and sites must submit their rank order list
to NMS. There are also special provisions
for applicants to submit their rank order
list as couples if they are in a relationship
and want to seek internships in similar
locations. NMS takes approximately two
weeks to run the match. On the Friday
before Match Day applicants are informed
whether or not they matched; sites are not
provided with this information. This was a
relatively recent change in order to provide
applicants who did not match with time to
prepare for entering the Clearinghouse on
Monday. On the Monday of Match Day
both sites and applicants are informed of
their match for the coming year. The com-
puter match in combination with clearly
stated Match guidelines has helped to
eliminate much of the pre-internship court-
ing rituals, as sites and applicants are not
allowed to request or provide any rank
related information. Those applicants and
sites that do not fill through the match may
participate in the Clearinghouse that
begins on Match Day. There is not currently
a match for APPIC member post-doctoral
programs.
Recent Trends
Our profession is facing a number of chal-
lenges and opportunities at present. Some
of the challenges that directly are impact-
ing the internship process include intern-
ship supply and demand issues and fund-
ing issues. In addition the internship match
and follow-up survey allow us to make
some observations regarding changing
demographics in our field.
Internship Supply and Demand Issues
While the number of internship positions
available to applicants has shown a modest
increase in recent years, the number of
applicants applying for internships has
continued to grow at a faster rate. In the
most recent match 617 sites participated in
the match, offering 2,757 internship posi-
tions. This represented an increase of 25
positions from the previous year. The
match successfully matched 2,448 appli-
cants, but 669 applicants were not matched
and 309 positions remained unfilled. If the
clearinghouse successfully filled the
unfilled positions, there were still 360 more
applicants than positions in the match.
This represents an increase of 131 more
applicants in the match in 2005 than in
2004. As a result of this ongoing and
increasing discrepancy, students are
increasingly anxious about the internship
match process.
17
Financial Pressures on Internship Sites
The difference in the number of internship
positions and applicants would suggest that
more internship positions could provide one
solution to the internship supply and
demand problem. At the same time, sites are
facing a number of concerns that make the
creation of more internship positions diffi-
cult. Medical centers are all under financial
pressure to produce revenue. Internships
and training continue to be evaluated and
reviewed regarding their contribution to the
financial health of the medical center. If the
internship training is not contributing to the
research mission by supporting the imple-
mentation and success of external grants
and/or to the clinical revenue stream,
they are most likely vulnerable to reduction
or closure. Recently, government GPE
(Graduate Psychology Education) funds and
GME (Graduate Medical Education) funds
became available. However, there are too few
of these to have made much impact on the
supply and demand issues in psychology.
In addition recent changes in regulations in
the Fair Labor Standards Act (FLSA) have
increased the minimum annual salary for
full-time employees in this country who
are not eligible for overtime pay to $23,660.
Depending on the way that internship
positions are created at different sites, the
legislation may or may not apply to intern-
ship positions. One of the determining fac-
tors seems to be whether interns are con-
sidered employees with benefits, or
whether the interns simply receive a train-
ing stipend. Since the median intern
stipend across all settings in 2004-2005 was
18
$19,400 (APPIC Directory data) one can see
that the FLSA legislation creates issues for
many sites. Some sites have needed to cut
internship positions, others are paying
overtime pay, while others have been able
to increase their stipend.
Demographics of Internship Applicants: This
year for the first time, APPIC asked appli-
cants who completed the post-match sur-
vey to provide demographic information.
This is information that has not been
requested at the time of the match, due to
concerns about the potential appearance of
discrimination. Results of the survey con-
ducted post-match suggest that at the pre-
sent time approximately 78% of internship
applicants are female, 22% of applicants
were male. Approximately 39 % are
coming from Psy.D. programs, while 61%
are coming from Ph.D. programs.
Approximately 59% of intern applicants
were under the age of 30, 31% of applicants
were in their 30’s, while 10% of internship
applicants were over age 40. Seventy eight
percent of intern applicants were white,
while 22% represented other racial or eth-
nic identifications.
Conclusion
As the demands and challenges of our
work change over time, we strive to meet
new demands and take advantage of new
technology. This is an ever changing land-
scape, and yet at the core internship train-
ing continues to provide a pivotal training
experience in the development of clinical,
counseling and school psychologists, much
as it always has.
DIVISION 29 EXECUTIVE COMMITTEE MEETING

Miami, Florida • January 14, 2005

(Clockwise) Armand Cerbone, Craig Shealy, Abe Wolf, Leon VandeCreek,

Linda Campbell, Jan Culbertson, John Norcross, and Tracey Martin.

19
20
WASHINGTON SCENE
A Few Dedicated Visionaries
by Pat DeLeon, former APA President
This is the time of year for commencement
activities, and I was able to attend two that
were particularly notable. At American
University, U.S. Senator Daniel K. Inouye
provided an historical perspective upon the
issues underlying today’s intense Senate
debate on the filibuster and the so called
“nuclear option” proposed by the Majority
Leader. “As I speak to you, a great debate is
raging in the United States Senate. It
involves a parliamentary action that is com-
monly referred to as the ‘filibuster.’ On the
first Tuesday of January 1963, I took my
oath of office as a Senator from the State of
Hawaii. Four weeks later I found myself
involved in what was later looked upon as
a historic debate on civil rights. The main
issue was the filibuster. Many insisted that
the filibuster was the stumbling block that
prevented passage of decent laws to protect
the rights and privileges of all citizens,
regardless of race, color, or religion.
“On January 31, 1963, I said: ‘I have heard
so often in the past few weeks, eloquent
and good men plead for the chance to let
the majority rule. That is, they say, the
essence of democracy. I disagree, for to me
it is equally clear that democracy does not
necessarily result from majority rule, but
rather from the forged compromise of the
majority with the minority. The philosophy
of the Constitution, and the Bill of Rights is
not simply to grant the majority the power
to rule, but is also to set out limitation after
limitation upon that power. Freedom of
speech, freedom of the press, freedom of
religion; what are these but the recognition
that at times when the majority of men
would willingly destroy him, a dissenting
man may have no friend but the law. This
power given to the minority is the most
sophisticated and the most vital power
bestowed by the Constitution....
“The majority leadership of the Senate has
insisted that these matters [federal judicial
confirmations] should be resolved with a
simple majority vote. To accomplish this
end, they would do away with the right of
the minority to filibuster. To those who
would advocate this position, I say to them
as I did 42 years ago: ‘You sow the wind,
for minorities change and the time will
surely come when you will feel the hot
breath of a righteous majority at the back of
your own neck. Only then perhaps will
you realize what you have destroyed.’”
The Senator made these remarks within the
context of a very personal experience:
“When I entered high school in 1939, I noted
that my parents, in filling out a school form,
had provided information that was surpris-
ing and stunning. I noted that my father
had indicated that he was not a United
States citizen. That was understandable
because he was born in Japan, and came to
Hawaii as a young child of three. I noted,
however, that my mother had also noted
that she was not a citizen. I was certain she
was born in Hawaii, and, therefore, a citizen
of the U.S. I took the form to her and said,
‘I think you made a mistake in filling out the
form,’ pointing to the citizenship question.
She looked at me with sad eyes and told me
that she had not made a mistake.
‘According to the law,’ she said, ‘an
American who marries a Japanese loses his
or her U.S. citizenship, and, therefore, I real-
ly don’t know what I am.’... I was horrified
to learn of this law, but this horror was mag-
nified when soon after December 7, 1941...
an Executive Order authorized and estab-
lished 10 concentration camps in desolate
areas in our nation....
“In 1988, an official apology to those who
were placed in the internment camps was
21
issued, and a token amount of redress pay-
ment was provided to surviving internees.
I cite this because it was a proud moment
for me to know that my country was strong
enough to admit her past errors and apolo-
gize. I cannot think of any other country
that has come forth to make such an admis-
sion of wrong and officially apologize....
“I could not help but conclude that history
is an ever-changing scenario, and that our
democracy was an ever-evolving concept.
For example, the minority opinion in the
Supreme Court may in later years become
the majority view. Slavery and segregation
are some of the numerous examples. Laws
may be repealed or amended....
Democracy is an imperfect concept slowly
seeking perfection.”
Personally, having attended an anti-war
candlelight service (at which Mary, of
Peter, Paul, and Mary heritage performed)
the night before the bombing, I was deeply
moved by the Senator’s observation that:
“However, I note that we Americans have
been quite impatient with people of other
lands who have not embraced our democ-
racy. In some cases, we have officially con-
demned these nations in very harsh terms,
and, in some, we have even used military
force. The question we Americans have
debated over the decades is simple but
profound: ‘Should we impose our will
upon other lands? Or should we adopt a
more peaceful path in convincing others of
the goodness of our system and philoso-
phy?’ I suppose this matter will be debated
for as long as we exist.” As one might
imagine, these words elicited a very
engaged response from the audience—
from both ends of the spectrum. On a per-
sonal note, I suspect that those protestors
who stormed out, subsequently re-entered
via the back door to see their loved ones
graduate later on in the program.
The second commencement exercise was
at Simon’s Rock College of Bard, located
in the hills of Great Barrington,
Massachusetts, known to many of our col-
22
leagues, and particularly by those who
attended the APA Opening Ceremony dur-
ing my Presidential year, as the home of
Alice’s Restaurant of Pete Seeger and Arlo
Guthrie fame. In the 1920s, when the land
upon which the college now stands was
mostly pasture and cultivated fields, a
local landmark—Simon’s Rock—was
plainly visible. And from the rock there
were extended views of the surrounding
Berkshire hills and the valley below.
Today, the rock—now surrounded by
trees—still sits on the mountainside
between the main and upper campuses.
When Elizabeth Blodgett Hall decided to
found an early college, she named it after
the rock and explained its significance by
describing what it meant to her when she
was an adolescent:
“Simon’s Rock is a glacial erratic on a
Berkshire hillside. The small band of
neighborhood children who built a cabin
there in the early twenties did not know
this until they grew up. At twelve and thir-
teen, their interest centered on the rock for
other reasons. It was a good place to get
away to. The adult world in the valley
below could be viewed from on high.
Grown men and women, teams of horses,
and Model T Fords all dwindled to a size
where one could imagine oneself compe-
tent to direct and control them. Yet the val-
ley remained to return to when one wea-
ried of freedom, wet feet, and raw bacon
burned at one end.
“And each time they returned they knew a
little more about a lot of things: that dry
wood and a proper draft make a big differ-
ence in a fire; that much snow makes little
water; that umbrellas opened at the top of
the rock will not suffice as parachutes for a
quick descent; that killing a squirrel with a
.22 is not much of a victory; that adults
may be more like oneself than one
thought.” Today’s Simon’s Rock college,
like its namesake, still offers a place for
young people to learn and gain perspec-
tive, a haven where they can explore,
exchange confidences, grow and dream
like the builders of that first cabin.
This year’s commencement speaker was
Eli Pariser, a Simon’s Rock alumnus. As
the program said: “Known to millions of
Americans through his political leadership,
particularly through the Internet, the 24-
year old Pariser is executive director of
MoveOn.org—a grassroots organization
dedicated to empowering ordinary
Americans to be catalysts for political
change. Pariser became a groundbreaker in
the movement to use the Internet for polit-
ical organizing when, 24 hours after the
events of September 11, 2001, he launched
a website calling for alternatives to a mili-
tary response to the terrorist attacks.... (He)
has directed MoveOn’s campaign against
the Iraq war – in the process tripling the
organization’s member base, which now
stands at 2.9 million. He also raised more
than $30 million from over 350,000 small
donors to support the efforts of MoveOn.”
Eli Pariser matriculated at Simon’s Rock at
the age of 15, graduating in 2000, summa
cum laude. An impressive resume.
The underlying, take-home message of
Eli’s address was: “There ain’t nobody here
but us chickens.” Or, stated another way,
“It is up to us as individuals and concerned
citizens to accept responsibility for our
own future.” There are no grand plans for
the future or infallible leaders. Living in a
democracy means there is only us.
Eli got me thinking about our profession of
psychology. Who are our visionary lead-
ers? Who is making a difference in our
daily lives? The individuals who quickly
came to mind during that rainy, and yet
sunny, afternoon were APA President Ron
Levant and Practice Directorate executive
director Russ Newman. Both have long
appreciated (as did former APA President
Norine Johnson) the importance of psy-
chology becoming one of the healthcare pro-
fessions and obtaining prescriptive author-
ity (RxP). For, the prescriptive authority
agenda has always been about revolution-
izing society’s definition of “quality” care
and ensuring that the all important psy-
chosocial-economic-cultural gradient of
care is granted appropriate priority by
society and our nation’s healthcare policy
experts. RxP is all about bringing psychol-
ogy into the 21st century. Nothing more;
nothing less.
In New Mexico, Elaine LeVine and Mario
Marquez have clearly made a difference,
as has Guam’s Mamie Balajadia and
Indiana’s Mike Murphy. Each of these
visionaries has been instrumental in hav-
ing RxP legislation enacted by their legisla-
tures. Elaine recently reported: “I have
been prescribing for about a month now. I
have had a number of positive experiences
already. Given the grueling efforts needed
to pass a prescribing psychologist law, my
short life as a prescribing psychologist
highlights why it is worth psychologists
pursing this path.... Now that I have a
license/certificate to prescribe, the physi-
cians have been quite willing to defer to
my judgment regarding the specific med-
ication. Their input regarding the medical
management of the patient has been very
helpful. There are new issues every day in
this new territory. For example: Who
should take my call when I am unavail-
able?—The best person would be a pre-
scribing psychologist because no one else
is prepared to deal with both the psycho-
logical and the medication issues, but so
far there are only two of us in the State!
There are issues regarding getting a DEA
license; the government has not figured out
there are prescribing psychologists yet.
Pharmacists wonder how to code us.
Pharmaceutical companies wonder if they
can sample us. All this commotion is actu-
ally kind of fun. It doesn’t have the same
vicious underpinnings as our legislative
battles. Out here in the primary care,
everyone seems to have the same goal of
getting care to the patients, in an under-
served and overburdened medical arena.
The question is how to get through and
over all the hurdles.”
In response to Elaine’s queries APA
Presidential citation recipient John Bolter
noted: “I got my DEA number about a
23
month ago. I think I was the first psychol-
ogist to get a DEA number. I don’t think
any of the [DoD] PDP people have actually
obtained a DEA number. Anyway, just
thought I would let you know the DEA has
resolved the issue of providing a DEA
number for medical psychologists (pre-
scribing psychologists).” Earlier this year,
Glenn Ally reported: “On February 18,
2005, the first prescription was written by a
civilian ‘medical psychologist’ in Baton
Rouge, Louisiana under the new RxP law
signed by Governor Blanco. Dr. John Bolter
wrote the first prescription—a prescription
for Remeron (for the trivia folks). This was
an historic moment for the Louisiana
Academy of Medical Psychology, for the
citizens of Louisiana, and for psychology
as a profession.” Our special thanks to
John and Jim Quillin—Louisiana is truly
on the cutting edge of change.
Recently, under Mike Sullivan’s tutorage,
Lance Laurence and his Tennessee col-
leagues have taken on the good fight.
Keith Hulse: “Well, we have some good
news and some bad news to report. The
bad news is that we were unable to pass
our prescriptive authority bill out of the
Senate General Welfare committee today.
We have concluded that it will not be pos-
sible to do so during this legislative ses-
sion. While we are disappointed, we are
not discouraged, and we are determined to
prevail in the long run. Passing this piece
of legislation is the hardest thing that TPA
has ever tried to do. In Louisiana, it took 10
years of work to pass a similar bill. This is
our second year. We have made remark-
able progress compared to where we start-
ed just two years ago in advancing our
‘case’ for the bill. In fact, the ‘case’ itself
was not disputed this year to any signifi-
cant degree, even by our opposition. If not
for ‘larger’ political forces outside our con-
trol, we might well have been writing you
a very different letter today. A year ago, we
were unable to move the bill out of any
committee. This year, we successfully
moved the bill out of the House
24
Professional Occupations subcommittee
despite there being an MD on the commit-
tee, and we also passed the bill untouched
out of the House Governmental
Occupations subcommittee. Unfortunately
for our efforts, the majority in the legisla-
ture shifted towards Republican, on the
coat-tails of the last Presidential election,
and the legislature this year has been
divided along party lines to an unusual
and unfortunate degree. Our bill became
caught up in that partisan battle. As a
result of this shift in the composition of the
legislature, in the Senate General Welfare
committee this year, we had two definite
‘yes’ votes unexpectedly thrown off the
committee and replaced with Republicans,
one of which was yet another Republican
MD. The vote today would have been
along straight party lines (had we allowed
it to go forward). We needed five of nine
votes to pass out of committee, but all five
Republican members of the committee, in
the end, signaled that they intended to vote
against our bill.
“The good news: there is much good that
has come out of this legislative effort,
despite our not passing the bill this year.
TPA’s ‘status’ in the legislature has never
been higher. We have earned an unprece-
dented overall presence and level of
respect. This status will outlast the out-
come of any given bill, RxP or otherwise.
Not a single bill adversarial to TPA was
dropped this year, which is unusual.
Increasingly, TPA is being looked to by the
legislature as THE expert in the area of
mental health. In the process of pursuing
the RxP effort, we have continued to build
strong relationships with many members
of the legislature, and those will also
endure far beyond this one bill. The size of
TCPA (TPA’s PAC), thanks to you all, has
increased over 400 percent in the past two
years(!). APA has given TPA substantial
grant support in the past two years, and
has also included Tennessee in its pilot pro-
ject utilizing their CAP Wizard website,
which has allowed literally thousands of e-
mails to be sent to the state legislators dur-
ing this session. And you all, our grass-
roots network, have responded unbeliev-
ably well to our calls. APA tells us that
Tennessee’s use of the CAP Wizard website
is an order of magnitude greater than any
other state’s. Your utilization of their web-
site has been greater than that of every
other state combined! That is totally to the
credit of you, the TPA membership. TPA’s
grassroots network has been phenomenal
and is the envy of every other state. Our
PowerPoint presentation and ‘white paper’
supporting the RxP agenda are both being
utilized nationwide to advance the case for
RxP. And rest assured, we have already
started today laying the groundwork for
passing our RxP bill next year.
“To quote Jim Quillin: ‘If we don’t quit, we
win.’ And to quote Margaret Meade:
‘Never doubt that a small group of
thoughtful committed people can change
the world; indeed it’s the only thing that
ever has.’ We hope that all of you will all
continue to be members of our now-not-
so-small group of thoughtful committed
people. Thank you for all your hard work
this year. Please seriously consider signing
up for RxP training. We are going to be ask-
ing for your help very shortly in the ‘off
season’ to begin to prepare for next year’s
legislative session.”
And finally in Hawaii, one can feel the flow
tide for psychology where two colleagues
who work within our state’s community
health centers, Jill Oliveira-Berry and Robin
Miyamoto, have taken the lead on behalf of
HPA’s RxP legislative efforts. Jill is a Native
Hawaiian and member of the APA
Committee on Rural Health. After extensive
public hearings focusing upon the critical
issue of access—and with the enthusiastic
support of the Hawaii’s Primary Care
Association and its centers’ medical direc-
tors—two Senate Committees recommend-
ed the enactment of legislation allowing
appropriately trained psychologists to pre-
scribe within federally qualified health cen-
ters. HPA was one vote short on the Senate
floor. However, subsequently House
Concurrent Resolution #255 passed both
bodies, “Establishing An Interim Task Force
On The Accessibility Of Mental Health Care
To Consider The Feasibility Of The State
Authorizing Trained And Supervised
Psychologists To Safely Prescribe
Psychotropic Medications For The
Treatment Of Mental Illness.” Jill: “The reso-
lution basically seeks to form a task force
that will consist of the chairs from the House
and Senate Health Committees, along with
two appointees from HPA and the Hawaii
Psychiatric Medical Association.” These two
legislators know the issues well and it is
anticipated that implementing legislation
will be introduced next session.
Aloha,
Pat DeLeon, former APA President
Division 29 – May, 2005
25
 2005 ROSALEE G. WEISS LECTURER
Dr. Marvin R. Goldfried
The American Psychological
Foundation (APF) and APA
Division 29 (Psychotherapy)
are pleased to announce
Marvin R. Goldfried, Ph.D.,
Distinguished Professor of
Psychology at Stony Brook
University, as the speaker for
the 2005 Rosalee G. Weiss
Lecture. The Rosalee G. Weiss
Lecture was established in
1994 by Raymond A. Weiss,
Ph.D., in honor of his wife,
Rosalee Greenfield Weiss,
Ph.D. The lecturer, who is an
outstanding leader in psychology, or a
leader in the arts or sciences whose work
and activities has had an effect on psychol-
ogy, presents at the annual APA
Convention.
Goldfried is a diplomate in clinical psy-
chology and is the recipient of numerous
awards including the APA Distinguished
Psychologist Award for Contributions to
Knowledge, Distinguished Psychologist
26
awards from the clinical psy-
chology; general psycholo-
gy; psychotherapy; and gay,
lesbian, and bisexual divi-
sions of APA, and the Award
for Clinical Contributions
from the Association for the
Advancement of Behavior
Therapy. He is Past
President of the Society for
Psychotherapy Research,
founder of the journal In
Session: Psychotherapy in
Practice and author of sever-
al books. Dr. Goldfried is
cofounder of the Society for the
Exploration of Psychotherapy Integration
(SEPI), and founder of AFFIRM:
Psychologist Affirming Their Gay, Lesbian,
and Bisexual Family. Dr. Goldfried will
present The role of relationship and technique
in therapeutic change on Saturday, August
20, 2005 from 3:00 p.m. – 3:50 p.m. in the
Washington Convention Center, Meeting
Room 143C.
RESEARCH
Therapeutic Work and Professional Development:
Main Findings and Practical Implications of a Long-Term International Study
Michael Helge Rønnestad & David E. Orlinsky
How do psychotherapists experience their
work with patients? What impacts do ther-
apists’ work experiences have on their pro-
fessional development? How does the
therapist’s level and state of development,
in turn, influence their therapeutic work?
These are the central questions explored,
empirically and theoretically, in a new
book titled How Psychotherapists Develop
(Orlinsky & Rønnestad, 2005) that we
summarize selectively and briefly here,
emphasizing the main findings and some
of their practical implications.
Background
In 1989, a group of international colleagues
in Society for Psychotherapy Research
(SPR) began a cooperative, self-supporting
study of psychotherapists’ experiences of
therapeutic work and professional devel-
opment. This group, the SPR Collaborative
Research Network,1 consisted of clinical
researchers who also were well-experi-
enced practicing therapists. We conceived
of our project as a study of, by, and for psy-
chotherapists, aiming to study the process-
es of therapeutic work and professional
development from the psychotherapist’s
own perspective.
Toward this end, we designed the
Development of Psychotherapists Common
Core Questionnaire (DPCCQ) to survey var-
ious professional and personal experiences
in the spirit of a wide-ranging interview
among colleagues. To date, our group has
gathered extensive information from more
than 7,000 therapists of diverse profes-
sions, theoretical orientations, and career
levels. These therapists represent two
dozen countries, with the largest groups
thus far from the United States (many of
whom were Division 29 members),
Norway, Germany, the United Kingdom,
and South Korea. The results reported in
our book are based on approximately 5,000
of these therapists, analysts, and coun-
selors, who were engaged in various forms
of individual, couple, family and group
psychotherapy.
Therapeutic Work and Practice Patterns
Two broad dimensions of therapeutic
work experience were identified induc-
tively by factor analyses of many specific
facets of work, such as therapists’ clinical
skills, difficulties in practice, coping strate-
gies, modes of relating to patients, and in-
session feelings. One broad dimension
clearly described an experience of Healing
Involvement. This consisted of current skill-
fulness, minimal difficulties, constructive
coping strategies, genuine personal invest-
ment in affirmative, receptive relation-
ships with patients, in-session experience
of flow (Csikszentmihalyi, 1990), and an
overall sense of therapeutic efficacy. The
other broad dimension clearly reflected a
parallel but contrasting experience of
Stressful Involvement. Therapists in this
case frequently reported multiple difficul-
ties in practice accompanied by defensive,
therapeutically unconstructive coping
strategies as well as in-session feelings of
anxiety and boredom.
These two dimensions are statistically
independent, and both are descriptive, in
varying degrees, of all our therapists’
experiences with their patients. The vari-
ables that most strongly predicted experi-
ences of Healing Involvement with
27
patients were the therapist’s theoretical
breadth, work setting support and satisfac-
tion, and the breadth and depth of case
experience across different treatment
modalities—as well as their positive work
morale (about which more later). Relatively
few therapist characteristics predicted
Stressful Involvement, suggesting that this
aspect of experience is more responsive to
current caseload and practice characteris-
tics, but work stress was greater for thera-
pists who felt little support or satisfaction in
their main work setting, who had no pri-
vate practice—and who were caught in a
process of demoralization.
Since Healing Involvement and Stressful
Involvement were statistically independent,
we were able to characterize therapists’
overall practice experience by distinguish-
ing between those who reported much (or
not much) Healing Involvement and little
(or more than a little) Stressful Involvement.
These distinctions allowed us to see four
broad patterns of current therapeutic work
experience, as follows. Approximately 50%
of our therapists experienced an Effective
Practice, featuring much Healing
Involvement and little Stressful
Involvement. Another 23% were in what
might be called a Challenging Practice, in
which there was much Healing Involvement
but also more than a little Stressful
Involvement. The “good news” is that near-
ly three-fourths of those we surveyed were
actually experiencing much Healing
Involvement in their therapeutic work.
By contrast, 17% of our therapists reported
a personally neutral but apparently unpro-
ductive pattern of Disengaged Practice, fea-
turing little Stressful Involvement but not
much Healing Involvement. Even worse,
about 10% of our therapists were involved
in a basically Distressing Practice, where
they experienced not much Healing
Involvement and more than a little
Stressful Involvement.
The incidence of Effective Practice
increased markedly in successively more
28
experienced therapist cohorts, from 40%
among novices to 60% among seniors,
with a total reporting of all those having
much Healing Involvement rising from
60% among novices to 80% among seniors.
A parallel decline was noted in the inci-
dence of Distressing Practice, which typi-
fied 20% of the novices but only 6-7% of
established, seasoned, and senior thera-
pists. Some of these differences may be
due to departure from clinical work by the
most distressed therapists, but much is
also likely due to therapists’ improvement
over time. What these figures demonstrate
dramatically is the relative vulnerability of
novice therapists, and their need for effec-
tive supervisory guidance and support.
Professional Development
Development was defined and assessed in
three ways. First, comparisons were made
among cohorts of therapists at different
career levels, as mentioned above. Six lev-
els were distinguished based on clinical
and statistical considerations: novices (less
than 1.5 years of work with patients);
apprentices (1.5 to 3.5 years); graduates (3.5
to 7 years); established therapists (7 to 15
years); seasoned therapists (15 to 25 years);
and senior therapists (with 25 to 50 years of
clinical practice). These cross-sectional
analyses were supplemented by measures
of the therapists’ experiences of their cur-
rent or ongoing development, and by vari-
ous measures of their cumulative career
development.
Analyses of ongoing development yielded
two independent dimensions, Currently
Experienced Growth and Currently
Experienced Depletion. Currently
Experienced Growth included a sense of
active change and improvement, a deepen-
ing understanding of therapeutic process,
enhanced skillfulness, enthusiasm for
practice, and a sense of overcoming past
limitations as a therapist. A major portion
of this can be interpreted as a continuing
renewal of the therapists’ work morale
(Orlinsky, Rønnestad, Ambühl et al., 1999),
which derives in large part from their
experience of Healing Involvement, and
enables them to continue engaging pro-
ductively with patients despite the stresses
of professional practice.
By contrast, Currently Experienced
Depletion included a sense of deteriorat-
ing skills, loss of empathic responsiveness
to patients, routinization of practice, and
growing doubt concerning the effective-
ness of therapy. This can be interpreted as
a process of demoralization resulting in
large part from the experience of therapeu-
tic work as a Stressful Involvement, which
tends to further undermine the therapist’s
ability to engage positively with patients,
producing a spiral of negative effects that
can lead to therapist burnout and potential
harm to patients.
Growth and depletion both are experi-
enced by therapists in response to their
practice experience, although in varying
degrees. Where Currently Experienced
Growth predominates, the therapist’s
overall sense is one of Progress. By contrast,
where Currently Experienced Depletion is
predominant, the therapist’s overall sense
is one of Regress. Where both are clearly
present, the overall experience is a confus-
ing one of Flux, with improvement felt in
some areas and deterioration in others.
Therapists who experience little depletion
but not much growth can be described as
in Stasis, of which the positive side is sta-
bility but the negative is stagnation.
Therapists’ experiences of Cumulative
Career Development were reflected in a sin-
gle second-order dimension that included
separate factor-analytically defined
dimensions of retrospective perceived
development, change from initial to cur-
rent levels of clinical skill, and level of
attained therapeutic mastery. Cumulative
Career Development was only modestly
correlated with years in clinical practice,
and in fact was more strongly related to
the breadth and depth of the therapist’s
case experience across diverse treatment
modalities—indicating that what one does
and learns has more to do with career
development than mere length of service.
Higher levels of Cumulative Career
Development were positively related to
Currently Experienced Growth, as expect-
ed, and were inversely related to Currently
Experienced Depletion. This means that the
harmful effect of experiencing clinical work
as a Stressful Involvement is attenuated or
buffered by advanced development, but
that, by the same token, relatively inexperi-
enced therapists are most vulnerable.
Our book presents a detailed, empirically-
grounded theoretical model of the recipro-
cal impacts of professional development
and therapeutic work experience, as well
as many other relevant findings, which we
hope interested readers will want to exam-
ine there. Here, in this brief article, we con-
clude by summarizing some of the practi-
cal implications explored in the book
based on our findings. These include rec-
ommendations with respect to profession-
al training, clinical supervision, and thera-
peutic practice.
Professional Training
The most important recommendation for
training is to ensure, as far as possible, that
novice and apprentice therapists experi-
ence Healing Involvement in their initial
work with patients, and that Stressful
Involvements be kept to a minimum.
Beginners are especially vulnerable to the
demoralizing impact of a Distressing
Practice, and may sustain personal harm
as well as fail to help their patients.
These recommendations require careful
case selection to match the skill level of
beginning therapists, as well as practical
education to provide them with relevant
skills and ample supervisory and peer
support. Given appropriate training and
supervision, early exposure to clinical
work is also recommended as therapists of
all orientations and career levels consis-
tently focus on practice as their major
source of learning. Moreover, we further
29
recommend that this early practice include
meaningful participation in diverse treat-
ment modalities—that is, in couple and
family and group psychotherapy with
more experienced co-therapists, in addi-
tion to standard one-on-one individual
therapy.
Clinical Supervision
The significance of supervision for thera-
pists is reflected in its consistent ranking
by practitioners at all career levels as the
second or third most important positive
influence on their development, following
learning from work with patient—and was
ranked as the most important influence by
novice therapists. The value of supervision
is expressed by the simple but convincing
fact that 56% of established therapists (7-15
years in practice) and 42% of seasoned
therapists (15-25 years in practice) report-
ed they were currently in supervision for
some of their cases. Thus many therapists
seek supervision well beyond what is for-
mally required to attain licensure.
Despite its positive importance, our study
also highlights a negative potential of
supervision, particularly when it involves
evaluation of the student or candidate.
This circumstance exaggerates the power
differential between participants and com-
promises the supportive part of the rela-
tionship. Recent empirical contributions
on non-optimal supervision have focused
on conflicts in supervision (Moskowitz &
Rupert, 1983), distorted and restricted
communication (Yourman & Farber, 1996);
supervisee non-disclosure (Ladany, Hill,
Corbett & Nutt, 1996) counter-productive
events (Gray, Ladany, Walker & Ancis,
2001), impasses (Nigam, Cameron &
Leverette (1997), and factors that con-
tribute adversely to supervision (Reichelt
& Skjerve, 2002). These negative aspects of
supervision erode the trainees’ self-confi-
dence, engender self-doubt about their
ability to become effective therapists,
evoke self-criticism as well as negative
personal reactions to the supervisor and
negative countertransference reactions to
30
patients. Reactions such as these in super-
vision when combined with the experience
of therapy as a Stressful Involvement can
be very detrimental to the development of
inexperienced therapists. The concept of
double traumatization introduced in our
book refers to the process in which the can-
didate is simultaneously stressfully
involved in work and also experiencing
conflict with a supervisor—a circumstance
in which Stressful Involvement is exacer-
bated by negative supervision, and a neg-
ative supervisory process is augmented by
Stressful Involvement. Supervisors should
be particularly aware of the potential for
double traumatization when supervisees
are experiencing Stressful Involvement
with clients, and be sensitive not only to
the quality of the supervisory alliance but
also the need to supportively confront and
repair alliance ruptures.
Therapeutic Practice
Probably the most important finding of
our study for practicing therapists, at all
career levels, is the reciprocal influence
between the clinician’s work morale and
their experience of therapeutic work.
Positive morale (in the guise of Currently
Experienced Growth) appears both as a
consequence and a major contributor to
Healing Involvement. Incipient demoral-
ization (in the guise of Currently
Experienced Depletion) similarly is atten-
dant upon and a forerunner to Stressful
Involvement. Although therapist self-
awareness is deeply embedded in the psy-
chotherapy culture, it is all too easy to dis-
count one’s sense of improvement or
depletion as a purely personal reaction,
rather than as an indicator of the freshness,
vitality, and optimism—or else the possi-
bly “technically correct” but unenthusias-
tic and indifferent manner—that one
brings to work with patients. The cyclical
relationship between currently experi-
enced development and therapeutic prac-
tice is an argument for all therapists to con-
tinually monitor their own sense of devel-
opment as well as quality of their work
involvement. To assist therapists in this,
we selected the most relevant items from
the DPCCQ to construct two brief self-rat-
ing forms for monitoring work involve-
ment (the Therapeutic Work Involvement
Scale) and professional growth and deple-
tion (the Current and Career Development
Scale). These are included as appendices in
our book, along with data enabling practi-
tioners to match themselves with compa-
rable therapists.
Other recommendations to practitioners are
addressed specifically to the small but sig-
nificant minorities who are experiencing
Stasis (not much growth and little depletion)
or Regress (not much growth and more than
a little depletion). To the one-in-five we esti-
mate are in Stasis, we propose that they take
steps to diversify their therapeutic work
(e.g., by doing couple, family, or group ther-
apy as well as individual therapy), and we
encourage them to explore diverse theoreti-
cal approaches. The key to both recommen-
dations is breadth: breadth and depth of
case experience across modalities, as a stim-
ulus to cumulative career development; and
theoretical breadth, as a facilitator of
Healing Involvement. This empirically
based advice converges with the recommen-
dation of Norcross (2000) to “Diversify,
diversify, diversify” as a principle of thera-
pist self-care. Another source of stimulation
that therapists in Stasis should consider is
voluntary, non-evaluative supervision,
either in an individual or peer group for-
mat—with the latter of particular value for
therapists who practice independently.
To the one-in-ten therapists who may be
caught in a state of professional Regress,
we strongly urge that they take steps to
protect themselves as well as their patients
from potential harm. Over 60% of novices
and nearly 60% of apprentices in Regress
are also in a Distressing Practice, where
they are experiencing more than a little
Stressful Involvement and not much
Healing Involvement. For them especially
(but also for all except the most senior
therapists) we recommend a change in
composition of caseload, where that is pos-
sible, to obtain a better match between
their current skills and the challenges pre-
sented by patients. Attempting to treat too
many difficult patients at the same time
may result in treating some not very well,
in addition to possible adverse effects for
the therapist.
A disproportionate number of those who
practice only in institutional settings (espe-
cially inpatient institutions) were also
found prone to professional Regress. The
source of this negative influence according
to our therapists appears to be the institu-
tional conditions of practice rather than
the challenge presented by treating severe-
ly disturbed patients, and therapists
should not be reluctant to treat such
clients. The addition of some private prac-
tice to the therapist’s work pattern seems
to insulate the clinician from professional
Regress, but in extreme circumstances
change in employment and work role are
alternatives to consider.
Finally, our study indicates that two leading
sources of professional growth for all thera-
pists are supervision (Orlinsky, Botermans
& Rønnestad, 2001) and personal psy-
chotherapy (Geller, Norcross & Orlinsky,
2005). These are important as sources of
motivational support and stimulation to
professional and personal growth. They
also support the process of continuous pro-
fessional reflection that Rønnestad and
Skovholt (2003) found to be an essential fac-
tor in therapist development. To facilitate
this, therapists can help themselves by
using aids such as the self-monitoring mea-
sures assessing therapeutic work involve-
ment and professional development includ-
ed in How Psychotherapists Develop.
Authors’ note
Michael Helge Rønnestad is professor of clinical
psychology at the University of Oslo
(helge.ronnestad@psykologi.uio.no). David
Orlinsky is professor of comparative human
development and social sciences at the University
of Chicago (d-orlinsky@uchicago.edu).
Communications about this article may be
addressed to either author.
31
Notes
1This article is a highly condensed summa-
ry of the major findings reported in How
Psychotherapists Develop, published by the
American Psychological Association in
2005
2David Orlinsky has served as the group’s
coordinator for North America and else-
where in collaboration, successively, with
Paul Gerin, Hansreudi Ambühl, and
Michael Helge Rønnestad, who served as
European coordinators for the project. The
group initially included (in alphabetical
order): Nicoletta Aapro (Switzerland),
Hansruedi Ambühl (Switzerland), Wouter
Backx (Netherlands), Jean-François
Botermans (Belgium), Christine Davidson
(USA), John Davis (England), Marcia Davis
(England), Alice Dazord (France), Paul
Gerin (France), Jean-François Iahns
(France), David Orlinsky (USA), Thomas
Schröder (England), Ulrike Willutzki
(Germany). They were soon joined by Peter
Buchheim (Germany), Manfred Cierpka
(Germany), Michael Helge Rønnestad
(Norway), and Hadas Wiseman (Israel),
while some also left (e.g., Backx, Davidson,
Iahns). The present international steering
committee consists of Botermans, Orlinsky,
Rønnestad, Schröder, Willutzki, and
Wiseman.
References
Geller, J. D., Norcross, J. C., & Orlinsky, D.
E. (Eds.), The psychotherapist’s own psy-
chotherapy: Patient and clinician perspec-
tives. New York: Oxford University
Press.
Gray, L. A., Ladany, N., Walker, J. A., &
Ancis, J. R. (2001). Psychotherapy
trainees’ experience of counterproduc-
tive events in supervision. Journal of
Counseling Psychology, 48, 371-383.
Ladany, N., Hill, C. E., Corbett, M. M., &
Nutt, E. A. (1996). Nature, extent, and
importance of what psychotherapy
32
trainees do not disclose to their supervi-
sors. Journal of Counseling Psychology, 43,
10-24.
Moskowitz, S. A., & Rupert, P. A. (1983).
Conflict resolution within the superviso-
ry relationship. Professional Psychology:
Research and Practice, 14, 632-641.
Nigam, T., Cameron, P. M., & Leverette, J.
S. (1997). Impasses in the supervisory
process: A resident’s perspective.
American Journal of Psychotherapy, 51,
252-272.
Norcross, J. C. (2000). Authoritative guide to
self-help resources in mental health. New
York, Guilford.
Orlinsky, D. E., Botermans, J.-F., &
Rønnestad, M. H. (2001). Towards an
empirically grounded model of psy-
chotherapy training: Four thousand
therapists rate influences on their devel-
opment. Australian Psychologist, 36, 139-
148.
Orlinsky, D. E. & Rønnestad, M. H. (2005).
How psychotherapist develop: A study of
therapeutic work and professional develop-
ment. Washington, DC: American
Psychological Association.
Orlinsky, D. E., Rønnestad, M. H., Ambühl,
H., et al. (1999). Psychotherapists’
assessments of their development at dif-
ferent career levels. Psychotherapy, 36,
203-215.
Reichelt, S., & Skjerve, J. (2002).
Correspondence between supervisors
and trainees in their perception of super-
vision events. Journal of Clinical
Psychology, 58, 759-772.
Rønnestad, M. H., & Skovholt, T. M. (2003).
The journey of the counselor and thera-
pist: Research findings and perspectives
on professional development. Journal of
Career Development 30, 5-44.
Yourman, D. B., & Farber, B. A. (1996).
Nondisclosure and distortions in psy-
chotherapy supervision. Psychotherapy,
33: 567-575.
 2005 RECIPIENT OF THE
APA DISTINGUISHED CONTRIBUTIONS TO
EDUCATION AND TRAINING

John C. Norcross, Ph.D., ABPP

The APA Division of training, professional gover-

Psychotherapy is pleased to
recognize that Dr. John C.
Norcross has been selected as
a 2005 recipient of the
APA/APF Distinguished
Contributions to Education
and Training Award. Dr.
Norcross is a Council
Representative from the
Division of Psychotherapy
and is also a Past-President of
the Division.
Dr. Norcross is being
acknowledged for the continuing impact of
his work on education and training in psy-
chology. The award criteria include posi-
tive influence in the teaching of students,
engagement in educational and training
research, development of instructional
materials that influence the direction of
nance, and promotion of con-
tinuing education.
Dr. Norcross’s scholarly pro-
ductivity and his educational
impact are of the highest
quality. His ongoing work in
chronicling the course of psy-
chotherapy in psychology
has been invaluable to the
work of the Division of
Psychotherapy. His gover-
nance and policy contribu-
tions are singular in their
value to the profession.
Dr. Norcross will be delivering his award
address at the APA convention in
Washington, DC. We look forward to your
joining us to celebrate this distinguished
recognition.

Invited Address
The Psychotherapist’s Own Psychotherapy:
Educating and Developing Psychologists

Friday, August 19, 2005

10:00-10:50
Meeting Room 204C
Washington Convention Center

33
34
35
36